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Rituximab Maintenance Treatment

Blood Cancers & Disorders | Last Active: 1 day ago | Replies (4)

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Profile picture for jerry48 @jerry48

My diagnosis is a LPL non-WM. A high kappa light chain count caused a peripheral neuropathy with profound lower leg weakness and that was my presenting symptom. Treatment was 4 months of bendamustine-rituximab followed by two additional months of rituximab. The bendamustine was stopped 2 months early since my kappa light chains had plateaued at a 90% decrease and I was starting to have some bothersome side effects.
Both of my oncologists at different facilities agreed that I should be on maintenance rituximab every 2 months for 2 years. The reasons were one - that the kappa light chain level had not reached what is considered a normal level (though it is debatable what is a normal level for a 77 year old), and two, the severity of the presenting neuropathy. (The neuropathy greatly improved within 2 months of treatment.)
Of course I did some searching through the web for the pros and cons of maintenance therapy and could find convincing arguments on both sides. I decided that I was happy with the treatment plan so far and would stay with what both docs were recommending.
I hope my experience might be helpful to you.

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Replies to "My diagnosis is a LPL non-WM. A high kappa light chain count caused a peripheral neuropathy..."

@jerry48 While the treatment protocol in my case was not a conventional one, it was effective and all credit to the oncologist.
However, the decision to start Rituximab maintenance seems probably motivated by the fact that the M Band isn't zero, which is the target set by the oncologist, based on conversations with him. Surprisingly he isn't too concerned about the following:
1. What are my **IgG, IgA and IgM levels** now?
2. What is my current **B-cell count/CD19 or CD20 level, if it has been measured?
I need more clarity before I agree to any further treatment because of risk of infection and will schedule a consultation for next week.